Organization
DAYBREAK YOUTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS RUSSELL (EXECUTIVE DIRECTOR)
(509) 444-7033
Entity
Organization
Contact information
Practice address
200 N MULLAN RD, SUITE 120, SPOKANE VALLEY, WA 99206
(509) 927-1688
(509) 444-7038
Mailing address
960 E 3RD AVE, SPOKANE, WA 99202-2241
(509) 444-7033
(509) 927-1851
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
32011600
WA
101YM0800X
Mental Health Counselor
32011600
WA
251B00000X
Case Management Agency
32011600
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011600
WA STATE DBHR
WA
05
—
1012387
—
WA
Enumeration date
07/31/2006
Last updated
09/22/2022
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